Aetna Open Choice PPO
IMPORTANT UPDATE: The Aetna Open Choice PPO will no longer be offered as January 1, 2014. read more
- Plan Benefit Summary (2013)
- Summary of Benefits and Coverage (2013)
The Aetna Open Choice PPO plan lets you access care both in and out of network whenever you need care.
See a network doctor for lower out-of-pocket costs. There are no referrals needed. As long as a health care provider is in the Aetna network, just make an appointment and visit.
Out of Network:
See any doctor …the choice is yours. If you want to visit a doctor who is not in the Aetna Open Choice PPO network, there are no restrictions or referrals. We want you to know that seeking care out-of-network is often vastly more expensive out of pocket than seeking care at an in-network health care provider.
Finding a Network Doctor or Facility
You do not have to visit a doctor or facility from the Aetna network — but you may want to. Before they are accepted into the network, doctors and health care professionals are reviewed for licensing and other credentials, quality of care, and office standards. They are reviewed periodically — even after admission to Aetna’s network — to confirm that they still meet these requirements.
Here’s how you can review a network doctor’s credentials:
1) Use DocFind®, Aetna’s online directory
Let DocFind help you find information on network doctors and professionals — in English or Spanish. You can access this information without enrolling in the plan.
You can get to Docfind by:
■ visiting your Aetna Navigator member website (member id required), or
■ visiting www.aetna.com
Search by name, specialty, gender, languages spoken or hospital affiliation. For example, search by “location” if you want to find a doctor close to your home or office. You can also get information on the doctor’s education and board certification.
2) Call Member Services at (888) 448-2849
Our Member Services representatives can answer questions about each network doctor’s medical education and experience. They may also know
how other members rated their experience with the doctor. Call them at the toll-free number on your member ID card.